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1522 Lone Oak Rdr INSPECTI4N RECURD Control No. 1076 CITY OF EAGAN PERMIT TYPE: Bi' i i 1' 1Ny 3830 Pilot Knob Road Permit Number: 00 14 f' h Eagan, Minnesota 55123 Date lssued: 09f18/92 ; (612) 681-4675 SlTE ADDRESS: Lo r 4 i t H 1. UC K t zEi APPLICANT: if,2: LpIrE AAK RD IaA1tTLEBEM PAUL i SECTION 9 ('61?) +154-4109 : • ? ?. ? 7' ? „ U{ ... .:h.. i, L . PERMLTS?JtB/T?YP? Jso?tr TYPE OF WORK: NEN ? CIE9GRIPTIOM liEYACHFIi Pamlt No. Permit Holder Daas Tibplwns # S/{N PLUMBING HVAC ELEGTRIC EIECTRIG kmpsotfon DO% htsp. Camnoeb Footi,gs 1 92 Foundabon FrartNng Roofirg Rough Plbg. I Rouqh Htg. Ntil. I i Flrepiaoe I Final Htg. Orsat Test Fln81 Pbg. Plbp. lnspsctor - No4Hy Plumber Corist. AAetef Engr./Plen Bidg. Flnel ??D Dedc Ftg. Declc Flnal weli Pr. oisp. CITY OF EAGAN Remarks -"????-' Addition Section 9 Lot Rik Parcel 10 00900 110 28 owner urc,?l Street 1522 Lor18 Oak Rd, stace EagaIZ,MN 55121 - ? _?.c???-.1 309s - E Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1968 106.75 30 Paid # SEWER LATERAL 1970 ZO WATERMAIN , # WATER LATERAL 1' 1970 1380.00 9.00 20 WATER AREA 1977 208.8O 1.2 15 * STORM 5EW TRK 1970 20 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 16O•o 3271 6-22-76 8UILDING PER. SAC 200. - PARK CITY OF EAGAN 3795 Pilof Knob Road Eogan, Mlnnesota 55122 Phone: 454-8100 '?-?TT0kTr-A/f-' PERMIT DAte: I-20-79 ? Site Address: Lot 1522 Icm- Oa}C R"er3 Block Sub/5ec. _14' 110--28 Receipt No.: Single Residential No. 3?Q ? Name ' Pma iiartiebm New/Aiter./Repoir. ? ? Address T522 i? Oak J%>V Cost of Instollotion City Phone: Permit Fee S • On Name Surchorge . ? Address 0 u ?• ., City _ Phone: Total This Permit is issued on the express condition that oll work shall be done in accordance with all appliwble Stote of Minnesoto Stotutes ond City of Eogan Ordinances. Building Official CITY ot tAGAN BUILDING PERMIT Owne: HARTLEBEN, N. PAU?L, ........................................................................ . ROAD Addrecs (presan!) 1522 ... ...LONE .... OAK. ............................................ Sullder .......... KNUT............... F...JE.....L......DHE......I...M ................................................ Addrecc 5243 BLOOMINGTON AVE....... SO.................. DESCAIPTIOIQ N4 4099 3785 Piloi Knob Aoad Eegan, Minnesola 55122 454-8100 Dela ........10/1/76 Biories To Be Uead For Fron! Depth Heigh! Eei. Coa! Parm!! Fea Ramarks PATIO DECK 1,850 9.00 1.00 s/c or 1522 LONE OAK ROAD - SECTIOPT 9 11011) This permit doas not aulhorise the use of sixeels, roads, alleys or sidewalks ao: dow it give !hs ownsr os 6fa ageat the tighS !o creafe any slluafion which is a auisance or which precenla a hasasd !0 2he hoelth, safelp, eoaveniencs and general weltare !o anpone in the eommunify. THIS PEAMIT MUST BE KEPT ON THE PREMISE WHILE TIiE WORK IS IN PAOGAESS. This is !o eerlifp. !hal.... KDILIM-..&J-ELD.H.fi-Sb1 ....................daspermisaion to aree! n............. E.ATI.O...DEGX.................. _nPOn the above described premise subjec! !o the provisions of all applicable Ord'utances fos the Citp of Eagan. ...... ..,?/... .-' -?-z•"-" .................."--._..."--............ Per ....l ..??.... . ? !h?.Y..7."_..............i?., 1 .... _......•_' Mayoz Suilding Iaspee2or YILLAGE OF EACAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 2002 Ea9on,MN 55112 DATE: 6/22/76 Zoning: ? No. oF Units: 1 owner: N. Pa Hartleben Address: f/) 1)4 ?!&'l-?1 ' Sire Address: 1522 Lo-ne Oak Ruad /o -a o o? •-/??•a1 same WATER TURNED OFF A CURB ? eter No.: 24803699 Connection Charge: 160.00 pd Size: 5/8 Fock Reader No.: 742432 I agrea Tdµ?py?witYthe Villaga o{ Eagan Ordinonca ??(? Y?,!??J I gY Date of Insp.: Account Deposit: Permi[ Fee: 10.00 pd Sun:harge: .50 pd - 60.00 pd Misa Chazges: Total: 1.30 Date Paid: Insp.: - } Minnesota State Board of Electricity 3950- University Ave., St. Paul, Minn. 55104-Phone 645-7703 ? - r REQUEST FOR ELECTRICAL INSPECTION R?3804 CHCK BELOW WOAK COVERED BY THIS REQUEST Type ot Building New Add. Rep. Check Appliwces Wved For Check Fquipment Wued For Home ? 151 ? Range ? 1'emporary Wiring ? Duplex ? ? ? WaterHeater ? Ligh[ingFirz[ures ? Apt. Bldg. 0 ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Fumace 0 Silo Unioader ? Industrial Bldg. ? ? ? Au Conditioner 13 Buik Milk Tank ? Farm ? ? ? List List Othei 0 ? ' ` ? p Heiets( Rehers? COMPUTE INSPECTION FEE BELOW Service Entiance Size: # Fee Feeders&.Subfeedets: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres 2 0 101 co 200 Amps. Above 200 Amps. 31 t A es Ab gik p 31 to 100 Am res Above 100 Amps. Transformers Re teCo "r Partinlorotheifee Signs 1 1 Sp 1 In c[io Minimum f Remazks T07AL E 10G 2.5 I, the Electrical Inspector, hereby certify that the above inspection has been m'trde?' (Rough-in) Date (Final) Date This request void 18 months from This reque.9t void 18 months from !D o04U? /? qv?a? R 53804 Date of this Request tlPril 13,7979 I, as [R Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 1522 Lonesak Road Section Township Which is occupied by Paul Hartlebeen Eagan Range County Dakota Is a roughin inspection required on this job? Ndn Yes ? Ready Now 13 Will Cap ? Power Supplier NSP Address Electrical Contractor Lightning IIectric Co. , Inc. Contractor's License No. 36288 (COmpany Name) Mailing Address 1987 Stillwater Avenue St. Paul, Minnesota 55119 {?Itttricai Contractor or Owner Making Is Installation) Authorized S?gnature . .? ??x-?-.c?.?- Phone No.?38-8896 o. ????? ????? ???? This inspection reques wiil nat 6e accepted 6y the State Baard unless proper inspection fee is enclosed. I II I II I II II RE?UEST FOR ELECTRICAL INSPECTION 6`114 MinnesoW State Board of Electricity 1821 s 0 W02 6 3 * Phone (612)s? A?v? raui, MN ssioa ? Home Duplex Apt. Bldg. Othe%: " New Addn ommercial Induskial Farm Remod Re air ir Cond. Htg. Equip. Water Hfr. Load Mgmf. Other. D er Ran e Ele<. Heat Tem .$ervice a6ove tha woik covered by this request. Enter remarks in fhis space ond on Ihe bock of fhe white copy only. re--p (acmeafi Calculate Inspecfion Fee - Thu Inspection Requesf will not be accepied without the correct (ee: Olher Fee 8 $ervice Enhance S¢e Fee # Circvils/Feeders Fee Mo6ile Home Park Stall 0 to 200 Amps 0 to 100 Amps Stree} Ltg./rraffi<Sig. Above 200 Amps o e 700 Amps Tlonsformef/Genemtor IN6PECTOq'SUSEONLY TOTAL Sign/Outline L}g. Xfmr. ? ? ? Alarm/Remote Confrol $Wimmin9 POOl I here mni Ihat 1 im d nml in ollohon de ibed herein on the dabs sloled Irfi9o}ion Boom Rough.ln - Date Special Inspedion Investigativefee _ F?nol ?.! DoMy THIS INSTALLATION MAY 9E OR)ERED UISCONNECTED IF OT COMPLETED WITHIN 1 MONTHS. 302- 2 6 3 g OFtIC US ONLY This reqoesr wid 18 months (rom volidanon dare pnnted in Ihis baz /fG - ? PLEASE PRINT OR TYPE - Q 9 Reqoml Wh? ^ ? Raugh-in inspecnon mqwred2 ? Yes 00-1 rYou m?sl <oll the inzpeclur when ready) impecnon Oiher Thon Roogh-In: ady Naw ? Will Cell DaM Ready I?,fcensed confraclor ? owner hereby requesf inspedion of the above elecfrical work at: Jo6 Aildress (SVee, eox, or Route o.? a ? ?one , Ciry Q ?I Lp Code S 1 SMion No. Townahip Nome ar No. Range No Fbe N. Counyl ( / Orcupont j ? Phane N. C??__ /'_ D ?(? Pov.er5upplier Addresz Elechim hoaor ine) ame) Conka r Lcense Na Maeror Lc. N. (Plonl Elea Only) CLC g Q J I M. d u( nlraclor r? Igp I, sMllcypn)? ? Au onzed ignaNr (Convo O+ne P rbrtnieg Insbllanon? _ /?4 ?-, P neNo ,6 w6 EB-OOOOlA10 95' STATEBOAitDC?'?EEINSTAUCTIONSONBACKOFVELLOWCOPY CITY USE ONLY LOT q BL V) RECEIPT #: 1 I SUBD. V, l,V Y,- 1 RECEIPT DATE: MECHANICAL PERMIT # ] 999 MECHANICi4L PERMIT (RESIDEMfIAL) CITY OF HAfiAN 3$30 PILOT KNOS RD EAfiAN MN 551 EY (651) 681-4675 Date• Complete this section onlv if you aze installing HVAC in a single family dwelling, townhome or condo under construction and not ownerloccuuied. - ii '-".C: v-100 iv1 ^u T L' ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 eaJ 30.00 6.00 State Surchazge .50 Total $ Complete this section onlv if you are remodeling, adding to, or repairing an existing single family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. New Alteration Repair _ Other Reminder: Call 681-4675 for inspections. ? Furnace Airconditioning _ Air exchanger Other $ 3G."vv" State Surcharge 50 Minimum Total Due Qn SITE ADDRESS: Z?-O N L _ C5 h?L ?(-, O OWNER NAME: _'TA v L_ t"? F 2Z LL l'?LN _ PHONE #: /0GJ I -q5 LLLy ? O9 (AREA CODE) INSTALLER NAME: ? E?k C? F N? k(N ? EAT ? ?t C? r??P?PHONE #: ? ( Z --7 ZLI' ( 59 ? (AREA CODE) STREET ADDRESS: )S\?) C- CITY: k N N E_N C?oTATE: M ZIP: 5cJyV? SI 1 ATURE O PERMITTEE L IfO BL c7l CITY USE ONLY RECEIPT #: 59 26)1 SUBD. / DATE: ???? 1996 MECHANICAL PERMOT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT-KNOB RD EAGAN, MN 55122 (612)681-4675 Please complete for: • single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on fumace V ./?y,1_.,Jn ?.?r ?r-yli?iftnjrg 4?l?_n girevn?.on?+er ; a, \/greea c\ 1e!g!? gtr, Date: -9 ( _ FEES ? Minimum Fee: Add-on/Ftemodel (existing residence onl $ 20.00 • HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @ $3.00 each) ? State Surcharge TOTAL lan ? SITE ADDRESS- OWNER NAME: N a,A k n _ PHONE #: srumano ?ff nm.s u.ro a? m ea.romTMxr co• INSTALLER NAME• .??,,.M,?:TV - WMDPWa, MN ssao"ooe STREET ADDRESS• OU424-2M CITY: PHONE #: ( STATE: . ZIP: ?t- VaERERf11 P I CITY OF EAGAN X3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: Control No. 1076 BUILAING 001455 09/18/92 ! SITE ADDRESS: 1522 I.ONE OAK RD LOT: 11 BLOCK: 28 SECTION 9 DESCRIPTION: DETACHEp 'Building PermiC Type ' Buildfnq`'Work Type ' UBC Occupancy Construction type Zoning Building Length ? Building Width .? REMARKS: 6ARAGE/ACCESSORY NEW M--1 V-N R-1 30 24 T?r;?'_•?,? l?'??? /it?-'i?-i?,,--.? +LI L' FEE SUMMARY: VALUATION Base Fee Plan Review Surcharge Total Fee $12,000 $135.00 $87.75 $6.00 $228.75 CONTRACTOR: OWNER: - Applicant - HARTLEBEN PAUL 1522 LONE OAK RD EAGAN MN 55121 (612)454-4109 I hereby acknowledge that Z have read this applicati6n and state that the information is correct and agree to comply with all applicable State of Mn. Stetutes and City of Eagan Ordinances. ? APPLICANT/PERMITEE SIGNATURE ISSUED BY: 91 NATUR , hRMIT # REACTIYATE CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 ` Reco SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. , COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 capy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot chan e is re uested onc ermit is issued. Date 9- ii-9a i / Valuation of work 3, o00 . o 0 Site Address: 151-Z? 1,0Aio " 92) &?,dn1 -/?"I?v ? STREET SUI7E x Tenant Name: (commercial only) IAT 1L BIACR ? a?? Y /{?_„ /? FusD. a P ?a P.I.D. M " , f/ , / _ vo 90 - ! - 2 Descri tion of work: DL:7,?\CHe'D c4aRac:F. The applicant is: IQ Owner 11 Contractor ? Other (Deeeribe) Name A_ EU Phone 4 Property LAsr FIRS, Owner Address 16-aa /„o,/e e,,Al_ STREET STE R City 5tate /Y/V Zip SS/a / Company Phone Contractor Address License # Exp. City State Zip Company Phone ArchitecU Engineer Name Registration # Address City State Zip Sewer 3 water licensed plumber . Processing time for sewer h water permits is two days once area has been approved. I hereby acknowledge that I have read this applicatton and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: zz. 2'4_P OFFICE USE ONLY BUILDING PERMIT TYPE O 01 Foundation ? 02 SF Dwg. O 03 SF Addition ? 04 SF Porch ? 05 Sf Misc. WORK TYPE I?' 31 New ?032 Addition ? 06 Duplex ? 07 4-Plex ? 09 S-Plex ? 09 12-Plex ? 10 Multi. Add'1 O 33 Alterations ? 34 Repai,r GENERAL INFORMATION ..? .....> ? . .: . ? 11 Apt./Lodging ? 12 Multi. Misc. el 13 6arage/Accessory O 14 Fireplace ? 15 Deck ? 35 Tenant Finish O 36 Move , Const. (Actual) v-u Basement sq. ft. (Allowable) v- N lst F1. sq. ft. UBC Occupancy M_I 2nd F1. sq. ft. Zoning R_I Sq. Ft. total 8 of Stories Footprint Sq. ft. Length On-site well Depth A4 ' On-site sewage APPROVALS,. Ptanning Building Engineering Variance REQUIRED INSPECTIONS ? Site ,'E!I.Footing O Mallboard _P? Final 'B Framing ? Draintile c,(T3s ? Insulation ? Fireplace Permit Fee j35,00 Surcharge 6.00 Plan Review g7,?5 License MWCC SAC City SAC Water Conn. Nater Meter Acct. Deposit S/M Permit S/N Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. CoPies Other Total: SAC % SAC Units v.iuatim: g 17r1 noa c24X3o ' 92ea Xjb= /? S 2 v ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 31 Demolish . MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Assessments }- ? Isr y / ?^',? OAk pi> -A? a' -??'- ?L 'n . $ S ? i ,. UParket? ??g U. Registered Lend Surveyor end Prdeaeiona! Gngineer Penland Ave. 30. ? r . MinneepollM Minn. ? Phone 50 1-7252 O dmm.e"s iron mamummc ., • PLAY OIP SURVEY.;:' ? _ .. , ? , ,• ? . .: . ? N rtsopER?i?Y oF the N:751'>olfhcE.15,9{fof f/1n1 par/ eF'4od,t0 t?V sec r,ahq rtrIT za ,. ? bcscribed es rouow< _Be9tn??n9?p?[.?/FL1?. //?/e o?,f??Gavl. tef? 1B.Td1 E. af ifs N?Yto_ t?tneeSSA-S9JY, .?9R9/ !'t fe /he N. /int o!' /ef (7) McCar/hf Aid9e f,+enee .f'S7's/E`aten9 i/ieN. /ioe ePsmml !af(Il__/?!Y4t_f_+`...t?.ihtlV? c?'?CC_fA?fy?/?rixeM7/'E. SGn fttt??,?E sf?y y?otr? ?o Q Peih? Whleh is 1053lf. f, ani YlDff S ol tht N.it/, tol'lier of Sa'd Gevf. lnt (/f t,hrnce_N._yeo ft to /he N/ins ,)P_so,d_covlrei nl_thg& crAYe a/s.np?favd ?W /int Tn MePeinf o;' drqinninq,trcep! lA'treaf tahen 40 tsunfy 1Poao?Nn./D. Aa ke tc Ca_yn tv F ^pnn. _ ' . ';r?t}S4e??ld?imu+4':? "'4.1:x+"M?1Ny'-? -'$-•.`::-Y...n- +-w:s:.'?.vt,,.,. ,t_ Apornf onlbeN/? poF(ie1dLeffVJec9•;7-zy wd.eh is 970 ff Eo,rf o{ ttie /?•??' ? q? ? cerner fberee?; i m m? I m ^?? ? c N j.1 g,N ?. ..?? ? e ?o .'..?,,c-'-•n?.-'w'e`.},.r'a'r[?,whL"_?s._,,:..?Cx,?u _.....?. , . . , . ?.. . .. . „ -? .. , CERTIFICATB OF SURVEY 1eu7'eW 14e 11n/?iny en' 1 hercby artify thet on 19.,?? 4ji. q I che propert.y dexribed aiwve nnd thet the eMve plet la?e eotrect Stete Req. No. 2055 . ' ? ' . ceprcxtlteUan d said Jbu// //y A [QbqH• . . j rl BUTLDY37G PERf3IT APPLwCA:ION LOT /I C) BLOCK PARCEL E SECTIOid DNMBSR SF UYJPLATTED Aate:4' 29- ? ? PDDRFSS OF PARCEL /?? A- .LG/?G /?,al e /i?f1'/ - 70"t03ITG OCCUPAPICY L'SE %O /?N c E£TIMATF,O COST OWI]EIL /y =lu? ?7?%?? ?/l? TELEPHONE NO. . r ADDxEss .CoAre D,oe .61/ - coNrRAeTOR ?% l?f'??/Eiry7 ff ssLEnsorE No. ? ? ADDRESS Note: Include site p2an, building plans, and energy calculations vJith this application Signed OE'FICE USE a'O VALUATIOiT af-jga:21 l SAC VIATER C0111VEC1SON YSATER n9ETER BUILDSNG PERMIT FEE ? i SURCHAItGE FLE - I'ZAT3 CF:ECIC FES PAFtK DEDICATIOId FEE OTHER TOTAL* ?z ? '. APPROVALS: ASSESSMEVT CLERK BUILDING DEPT. POI,ICE DEPT. r4AmER & SL°rSER DEPT. EIRE DEPT. PAR& DEPT ? MASTER CARD LOCATION 1522 LONE OAK ROAD - /,e 0D9DD //D i2 ?' OWNER HARTLEBEN, N. PAUL - STRUCTURE AND LAND USED AS Section 9 ? /-Ip % Permit I I No. ? `Issued ? 6 Issued To Contractor Owner BUILDING Ojj? - ? -9y'Z3/76 Knut Fjeldheim PLUMBING GESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER I OTHER Items Approved (Initiai) Date Remarks Distance From Well FOOTI NG SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIEID FT. FINAL ELECTRICAL HE.4TING DEPTH OF WELI GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER J'? h/" Violatians Noted on Back COMMENTS: EAGA2I TOWNSHIP 3795 Pilot Rnob Road St. Paul, Minnesota 55111 Telephone 454-5242 PFRMIT FOR WATER SL+RVIC$ CONPIECTION Date: June 5. 1969 Silling Name: N. Paul Hartleben pumeT• N. Paul Hartleben Plumber: ldaa°a1 Pl?vnbj'q.'=W°°+,^g ^o. Meter Number: 284 %0 61)96o j/D ?iY Site Address: 1522 Lone Oak Rd. Billing Addxeas 1522 Lone Oak Rd. Having water brought up to house, Meter No. Permit Fee 7• ??- but not connecting at this time. I Meter Reading Meter Dep. Meter Sealed: Yea_ lAdd'1 Chg. NO I 1bta1 Chg. Building is a: Residence X Multiple ISo. Units Commercial Industrial Other Inspected by Date Remarka: By: Chief Iaspector In consideration of the issue and deliverq to me of the abwe permit, I hereby agree to do ttm proposed work ia accordance with the rules and regulations of &agan Towaship, Dakota County, Mianesota". gy;?lj-??/.??,?..Fr„_ .? rro.?r i ? T. ? o? 1,• g z u e+•ng; Cn Please notify the above office when ready for inspection and connection. lD OD?'10? /1 t5 Z? EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: June 5. 1969 OWNER• N. Paul Hartleben NUMBER gW 410 Addresa 1522 Lone Oak Rd. PLUMBER W enzel Plumbing & Heating TypE OF PIPE Heavy Cast Iron DESCRIPTION OF BUIIDING Industrfal Commercial Residential Multiple Dwelling No. of un£ts X Location of Connections: Connection Charge 200.00 pd. Account Dep. 15.00 pd. Permit Fee Street Repairs Total Inspected by: Date Remarks• Sy Chief InspecCOr In consideration of the issue asad delivery to me of the above pezmit, i hereby agree to do the proposed work in accordance with the rules and regulations of Eagan 1bwmship, Dakota County, Minneaota By Wenz 1 Plumbing & Heating Co. Please notifq when ready for.inepection and connection and before any portion of the work is covered. 2006 RESIDENTIAL BUILDING rERMiT nrrLrcaTTON City Of Eagaa 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reouiremenls 3 regnstered site surveys showing sq. R of lot, sq. ft of house; and all roofed areas (20% maximum lot coverege allowed) 1 Soils Report if proposed building is to be placed on distur6ed soil 2 cople.s ot plan showing beam & window sizes, poured found design, etc. 1 set of Energy Calculations 3 copies of T2e Preservation Plan if lot platted after 71153 Rim Joist Detail Opfions selection sheel (buildin9s with 3 or less unAS) Minne3asco mechanicel venGlation fortn RemodeUReoair Reauirements 2 wpies of plan showing fooGngs, beams, joists 1 set of Energy Calala6ons for heatei additions 1 site survey for additions & decks AddNOn - indicafe if on-sfte seplic system Offic'e l1seonl'v Ceil of SiiiyeY,R'e"Cd-=?'-:=-?:r•° `-Y. `•_?N ._;. SqilsRepoAxx.?=?'?d'.;:F?:?? l'ree;Pfg's?P1an:R"'eai;` 7ree Pie@ Reqiil?red ` -?? ; On-_"sile`Septic S}'S1em .''..Yt'N Date _!T_/ _2?k_/ Ob Si[eAddress Construction Cost /4 3 e0°.° Unit/Ste # F Description of Work /ID C- - V1.0 0 I Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner 124 •.? 6G c2-r ???EV?, Telephone #((-G1)?5 I V_ Xn k 111.?? Contractor ? Address _a2164p-? w ppu_P? ?u • State `AA, ,n. -°-- Ci? ?A V-F1, tr_. . Zip 'SSOq 4 Telephone#(qSa-) 880-09$9 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesob Rules 7672 Energy Code CategOry , Residential Ventilahon Category 1 Worksheet • New Energy Code Wodcsheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted In ihe last 12 months, has the City of Eagan issued a percnit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/ W ater Contractor Telephone #( Telephone #( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Nanr6 Applicant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA169580 Date Issued:06/01/2021 Permit Category:ePermit Site Address: 1522 Lone Oak Rd Lot:011 Block: 028 Addition: Section 9 PID:10-00900-28-110 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - N Paul & Mildred B Hartleben 1522 Lone Oak Rd Saint Paul MN 55121--111 Midwest Exteriors Mn 7920 Hill Trail N Lake Elmo MN 55042 (651) 346-9477 Applicant/Permitee: Signature Issued By: Signature